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How do people with diabetes value self-management support interventions?

Research aims to estimate the value of self-management of diabetes to patients both in quality adjusted life-years (QALY) and in monetary terms.

Follow on work aims to develop a Patient Reported Outcome Measure (PROM) for diabetes

Led by Professor John Brazier, University of Sheffield

Study 1 is due to be completed in early 2016 and study 2 in early 2017

Study 1 – understanding the value of self-management of diabetes

Patient self-management is crucial for the control of blood glucose, and there is strong evidence showing that self-management is essential to maintain ideal blood glucose levels and to avoid long-term diabetes-related events.

The overall aim of this study is to systematically identify, develop and value self-management for diabetes using both a QALY value and a monetary value. These can then be used to inform the design and assessment of self-management interventions. This research involves three stages covering the development, management and analysis of a Discrete Choice Experiment (DCE) undertaken with diabetes patients.

Firstly, a descriptive system will be derived consisting of up to three attributes covering self-management using a qualitative survey with patients and up to four attributes from an existing patient reported outcome measure for diabetes.

Secondly, these attributes will be valued using a DCE conducted online using two approaches including:

duration as an attribute

cost as an attribute.

Thirdly, the DCE results will be analysed using regression analysis to produce QALY values and monetary values for the attributes of self-management.

Study 2 – developing a patient reported outcome measure (PROM)

This second, follow-up, study will build on the work outlined above. The aim is to test the psychometric properties of the descriptive system developed in the discrete choice experiment in order to develop a new patient reported outcome measure (PROM) for diabetes that includes self-management. This PROM could then be used in the evaluation of new (and established) interventions for diabetes.

The work has two stages:

Firstly, focus groups comprising diabetes patients (type 1 and type 2) will be asked to comment on the content and practicality of the descriptive system, including how long it takes to complete, whether it is understandable, clear and complete.

Secondly, the descriptive system will undergo psychometric testing through a longitudinal survey with approximately 400 diabetes patients. Data will also be collected on diabetes; type, duration, medication, and current blood glucose levels. Data will be collected at more than one time point in order to allow for testing of responsiveness.

Results will be open access published and the new PROM will be made freely available for use in the NHS.